32 Anti Diabetic Drug questions

Which of the following is a rapid-acting insulin with an onset of action of less than 15 minutes? A) insulin glargine (Lantus) B) insulin aspart (Novolog) C) regular insulin (Humulin R) D) insulin detemir (Levemir)

B Insulin aspart is a rapid-acting insulin. Insulin glargine and insulin detemir are long-acting insulins. Regular insulin is short acting.

Which information should the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) a.) Take your medication only as needed. b.) Report symptoms of anorexia and fatigue. c.) Explain dietary changes are not necessary. D.) Advise to avoid smoking and alcohol consumption. E.) Instruct that it is okay to skip breakfast 1 to 2 times per week.

B, D

Assuming the patient eats breakfast at 8:30 AM, lunch at noon, and dinner at 6:00 PM, he or she is at highest risk of hypoglycemia following an 8:00 AM dose of NPH insulin at A) 10:00 AM. B) 2:00 PM. C) 5:00 PM. D) 8:00 PM.

C Breakfast eaten at 8:30 AM would cover the onset of NPH insulin, and lunch will cover the 2 PM time frame. However, if the patient does not eat a mid-afternoon snack, the NPH insulin may be peaking just before dinner without sufficient glucose on hand to prevent hypoglycemia.

A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia? a. 9:00 AM b. 11:30 AM c. 4:00 PM d. 8:00 PM

ANS: A The rapid-acting insulins peak in 1 to 3 hours. The patient is not at a high risk for hypoglycemia at the other listed times, although hypoglycemia may occur.

Blood levels of hemoglobin A1c are good indicators of the patient's compliance with the therapy regimen for several months previously. 1. True 2. False

Correct answer: 1 (true) Rationale: The hemoglobin A1c reflects how well the patient has been doing with diet and drug therapy over the preceding 2 to 3 months.

A woman who has type II diabetes is now pregnant. She wants to know whether to take her oral antidiabetic medication. What instructions will she receive? 1. She should continue the antidiabetic medication at the same dosage. 2. The antidiabetic medication dosage will be increased gradually throughout her pregnancy. 3. She will be switched to insulin therapy while she is pregnant. 4. She will not receive any antidiabetic medication while pregnant and will need to monitor her dietary intake closely.

Correct answer: 3 Rationale: Oral antidiabetic medications are generally not recommended for pregnant patients because of a lack of firm safety data. Insulin therapy is the only currently recommended drug therapy for pregnant women.

The patient is being discharged home with insulin aspart (NovoLog) and insulin isophane suspension (NPH). Which information does the nurse include when providing discharge teaching to the patient? 1. Store the insulins in the refrigerator. 2. Shake the insulins for 1 full minute before use. 3. Administer the injection at a 30-degree angle to your skin. 4. Draw up the insulin aspart (NovoLog) first and then draw up the insulin isophane suspension (NPH) into the same syringe

Correct answer: 4 Rationale: The rapid-acting (clear) then the intermediate-acting (cloudy) insulins should be mixed in the syringe after the appropriate amount of air has been injected. Insulin is stored at room temperature when it will be used within the month. The injection should be administered at a 90-degree angle for patients who have adequate body fat and at a 45-degree angle for patients who are very thin. Insulins should be rolled prior to administration and not shaken.

The nurse is preparing to administer an intravenous (IV) insulin injection. The vial of Regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which should the nurse do? 1. Discard the insulin and obtain another vial. 2. Wait for the insulin to thaw at room temperature. 3. Check the temperature settings of the refrigerator. 4. Rotate the vial between the hands until the medication becomes liquid.

Discard the insulin and obtain another vial.

Which insulin can be administered by continuous intravenous infusion? A) insulin glargine (Lantus) B) insulin aspart (Novolog) C) regular insulin (Humulin R) D) insulin detemir (Levemir)

c

Which insulin can be administered by continuous intravenous (IV) infusion?

REGULAR INSULIN (Humulin R)

Acarbose (Precose) is prescribed to treat a client with type 2 diabetes mellitus. Which instruction should the nurse provide when teaching the client about this medication? 1. Take the medication at bedtime. 2. Take the medication with the first bite of each regular meal. 3. The medication will be used to treat symptoms of hypoglycemia. 4. Headache and dizziness are the most common side effects of this medication

Take the medication with the first bite of each regular meal

The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse should provide which instruction to the patient for insulin administration?

"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin."

The nurse understands that which is the action of rosiglitazone (Avandia)? 1. Reduces insulin resistance. 2. Increases glucose secretion. 3. Delays absorption of dietary carbohydrates. 4. Increases insulin release from the pancreas.

1. Reduces insulin resistance. (Thaiazolidinediones aka Glitazones reduce inulin resistance in type 2 ppl)

A sulfonamide is prescribed for a client with a urinary tract infection. The client has diabetes mellitus and is receiving tolbutamide (Orinase). Because the client will be taking these two medications, which prescription should the nurse anticipate for this client? 1. Increased dosage of tolbutamide 2. Decreased dosage of tolbutamide 3. Increased dosage of sulfonamide 4. Decreased dosage of sulfonamide

2. Decreased dosage of tolbutamide

The nurse in the health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed metformin (Glucophage). What preexisting disorder, if noted in the client's record, would indicate a need to collaborate with the HCP before instructing the client to take the medication? 1. Foot ulcer 2. Emphysema 3. Hypertension 4. Hypothyroidism

2. Emphysema Metformin is contraindicated in patients with renal disease or renal dysfunction (serum creatinine level higher than 1.5 mg/dL in males or higher than 1.4 mg/dL in females). Because metformin is primarily excreted by the kidneys, it can accumulate in these individuals, increasing the risk of development of lactic acidosis. Other contraindications include alcoholism, metabolic acidosis, hepatic disease, heart failure, and other conditions that predispose to tissue hypoxia and increase the risk of lactic acidosis.

A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks the home care nurse about the purpose of the medication. The nurse should instruct the client that the purpose of the medication is to treat which problem? 1. Lipoatrophy from insulin injections 2. Hypoglycemia from insulin overdose 3. Hyperglycemia from insufficient insulin 4. Lipohypertrophy from inadequate insulin absorption

2. Hypoglycemia from insulin overdose

The emergency department nurse is caring for a client admitted with diabetic ketoacidosis. The health care provider prescribes intravenous (IV) insulin. The nurse plans to prepare which type of insulin for the client? 1. Insulin glargine (Lantus) 2. Regular humulin (Humulin R) 3. Isophane insulin NPH (Humulin N) 4. 50% human insulin isophane/50% human insulin (Humulin 50/50)

2. Regular humulin (Humulin R) can be given IV

The nurse understands that which is an advantage of insulin glargine (Lantus) over other extended-release insulins? 1. Has a distinct peak 2. Can be administered intravenously 3. Carries a decreased risk of hypoglycemia 4. Does not require finger-stick glucose monitoring

3. Carries a decreased risk of hypoglycemia

The health care provider has prescribed Humulin R insulin 6 units and Humulin N insulin 20 units subcutaneously to be administered every morning. How should the nurse prepare to administer insulin? 1. Shaking the Humulin NPH insulin vial to distribute the suspension 2. Administering Humulin R and Humulin NPH insulin in separate syringes 3. Drawing up the Humulin R first and then the Humulin NPH insulin in the same syringe 4. Drawing up the Humulin NPH insulin first and then the Humulin R in the same syringe

3. Drawing up the Humulin R first and then the Humulin N insulin in the same syringe

The nurse is completing a health history for an insulin dependent client who has been self-administering insulin for 40 years. The client reports experiencing periods of hypoglycemia followed by periods of hyperglycemia. What is the most likely cause for this pattern of blood glucose fluctuation? 1. Eating snacks between meals 2. Initiating the use of the insulin pump 3. Injecting insulin at a site of lipodystrophy 4. Adjusting insulin according to blood glucose levels

3. Injecting insulin at a site of lipodystrophy

When caring for a pregnant patient with gestational diabetes, the nurse should question a prescription for which drug? a.)Insulin glargine (Lantus) b.) Glipizide (Glucotrol) c.) Insulin glulisine (Apidra) d.) NPH insulin

b.) Glipizide (glucotrol) since its oral not injection and its pregnancy

Pramlintide (Symlin) is added to the treatment plan for a patient with type 1 diabetes. When teaching the patient about this medication, the nurse recognizes that A) pramlintide slows gastric emptying. B) pramlintide increases glucagon excretion. C) pramlintide works to prevent side effects of insulin. D) pramlintide is an oral drug administered 15 minutes before meals.

A Pramlintide is a synthetic form of the naturally occurring hormone amylin. It works by slowing gastric emptying, suppressing glucagon secretion, and centrally modulating appetite and satiety. It is only administered subcutaneously.

When administering 30 units regular insulin and 70 units NPH insulin, the nurse will perform which action? A) Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin. B) Inform the patient that mixing insulins will help increase insulin production. C) Rotate sites at least once weekly and label the sites used on a diagram. D) Use a 23- to 25-gauge syringe with a 1-inch needle for maximum absorption.

A rawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could cause an alteration in the onset of action of the regular insulin.

The diabetes nurse specialist conducts a teaching session to a group of nursing students regarding sulfonylureas, oral hypoglycemic medications used for type 2 diabetes mellitus. Which statement, describing the primary action of these medications, should the nurse include in the teaching session? 1. "Sulfonylureas decrease insulin resistance." 2. "Sulfonylureas inhibit carbohydrate digestion." 3. "Sulfonylureas decrease glucose production by the liver." 4. "Sulfonylureas promote insulin secretion by the pancreas."

4. "Sulfonylureas promote insulin secretion by the pancreas

Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.) A) Stimulate insulin secretion from beta cells B) Increase hepatic glucose production C) Enhance action of insulin in various tissues D) Inhibit breakdown of insulin by liver

A, C, D The sulfonylureas stimulate insulin secretion from the beta cells of the pancreas; enhance the actions of insulin in muscle, liver, and adipose tissue; and prevent the liver from breaking insulin down as fast as it ordinarily would (reduced hepatic clearance). Increased hepatic glucose production would serve to increase serum glucose levels, the opposite effect of oral hypoglycemic drugs

A client must learn how to mix Humulin R and Humulin N insulin in the same syringe. The nurse should include which teaching point in the instructions to the client? 1. Keep both bottles in the refrigerator at all times. 2. Take all of the air out of the bottle before mixing. 3. Draw up the Humulin N insulin into the syringe first. 4. Rotate the Humulin N insulin bottle in the hands before mixing.

4. Rotate the Humulin N insulin bottle in the hands before mixing.

A nurse is caring for a client recently diagnosed with type 2 diabetes mellitus who has been prescribed glipizide (Glucotrol XL). What is the most important point for the nurse to include in teaching this client about this medication? 1. Take the medication at least 1 hour after eating. 2. Make sure to take the medication every 12 hours. 3. Take measures to prevent and treat hyperglycemia. 4. Swallow the medication whole and never crush or chew it

4. Swallow the medication whole and never crush or chew it.

The nurse is caring for a patient scheduled to undergo a cardiac catheterization procedure utilizing iodine-based contrast material. The nurse would question an order for which medication to be given to this patient the day before the scheduled procedure? A) acarbose (Precose) B) metformin (Glucophage) C) repaglinide (Prandin) D) rosiglitazone (Avandia)

B The concurrent use of metformin iodinated (iodine-containing) radiologic contrast media has been associated with both acute renal failure and lactic acidosis. Therefore metformin should be discontinued at least 48 hours prior to any radiologic study requiring such contrast media and should be held for at least 48 hours after the procedure.

Which drug will the nurse tell the patient is a long-acting insulin? 1. Insulin glulisine (Apidra) 2. Insulin isophane suspension (NPH) 3. Insulin detemir (Levemir) 4. Regular insulin (Humulin R)

Insulin detemir (Levemir) or insulin glargine (lantus); which is not listed

A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question? 1. "It will boost the cells in your pancreas if you have insufficient insulin." 2. "It will help promote insulin absorption when your glucose levels are high." 3. "It is for the times when your blood glucose is too low from too much insulin." 4. "It will help prevent lipoatrophy from the multiple insulin injections over the years."

"It is for the times when your blood glucose is too low from too much insulin."

Pramlintide (Symlin) is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information should the nurse include when teaching the patient about the action of this medication? 1. Pramlintide slows gastric emptying. 2. Pramlintide increases glucagon excretion. 3. Pramlintide stimulates glucose production. 4. Pramlintide corrects insulin receptor sensitivity.

1 Pramlintide slows gastric emptying.

The nurse is monitoring a client receiving glipizide (Glucotrol). The nurse knows that which finding would indicate a therapeutic outcome for this client? 1. A decrease in polyuria 2. An increase in appetite 3. A glycosylated hemoglobin of 10% 4. A fasting blood glucose of 220 mg/dL

1. A decrease in polyuria

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should provide which instructions to the client? Select all that apply. 1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide. 6.Muscle pain is an expected effect of metformin and may be treated with acetaminophen (Tylenol).

1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episode

A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply. 1. Hypoglycemia may be experienced before dinnertime. 2. The insulin dose should be decreased if illness occurs. 3. The insulin should be administered at room temperature. 4. The insulin vial needs to be shaken vigorously to break up the precipitates. 5. The NPH insulin should be drawn into the syringe first, then the regular insulin

1. Hypoglycemia may be experienced before dinnertime. 3.The insulin should be administered at room temperature.

An 8-year-old boy is being treated with desmopressin (DDAVP). Understanding the purpose of this medication, the nurse should set which client goal? 1. The boy will have 5 nights in sequence without enuresis. 2. The boy will have increased urine output to 2400 mL per day. 3. The boy will have an increase in white blood cell count to 4000 cells/mm3. 4. The boy will have decreased use of the metered dose inhaler to three times per week.

1. The boy will have 5 nights in sequence without enuresis.

The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of insulin into each vial

1. Withdraws the NPH insulin first rd question! Its always regular than insulin its also always given at 90 degress unles pt is emaciated

The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention? 1. Withhold the medication and call the HCP, questioning the prescription for the client. 2. Administer the medication within 60 minutes before the morning and evening meal. 3. Monitor the client for gastrointestinal side effects after administering the medication. 4. Withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration

1. Withhold the medication and call the HCP, questioning the prescription for the client

The nurse monitors the blood glucose level of the client who received Humulin NPH insulin at 7 am with an understanding that the client may experience a hypoglycemic reaction during which time frame? 1. 9 am to 11 am 2. 11 am to 7 pm 3. 7 pm to 11 pm 4. Midnight to 6 am

2. 11 am to 7 pm its intermediate acting

A client with diabetes mellitus taking daily Humulin N insulin has been started on therapy with dexamethasone (Decadron). The nurse anticipates that which adjustments in medication dosage will be made? 1. A change to oral diabetic medications 2. An increased dose of Humulin N insulin 3. An increase in the amount of daily dietary calories 4. A lower dose of dexamethasone (Decadron) than usual

2. An increased dose of Humulin NPH insulin dexamethasone being a glucocorticoid means increase gluscose so increase insulin as response?

A nurse is providing teaching regarding acarbose (Precose). The nurse should tell that client that which expected side effect(s) may occur with this medication? 1. Tachycardia 2. Hypoglycemia 3. Tinnitus and decreased hearing 4. Abdominal distention and diarrhea

4. Abdominal distention and diarrhea ALL Alpha-glucosidase inhibitors do this

Metformin (Glucophage) is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client's teaching plan? 1. Weight gain 2. Hypoglycemia 3. Flushing and palpitations 4. Gastrointestinal disturbances

4. Gastrointestinal disturbances

Lispro insulin (Humalog) is prescribed for the client, and the client is instructed to administer the insulin before meals. When should the nurse instruct the client to administer the insulin? 1. 45 minutes before eating 2. 60 minutes before eating 3. 90 minutes before eating 4. Immediately before eating

4. Immediately before eating or 15min before?

Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours? A) insulin glargine (Lantus) B) insulin glulisine (Apidra) C) regular insulin (Humulin R) D) NPH insulin (Humulin N)

A Insulin glargine has a duration of action of 24 hours with no peaks, mimicking the natural, basal insulin secretion of the pancreas.

Which information should be included in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.) A) Limit your alcohol consumption. B) Report symptoms of anorexia and fatigue. C) Take your medication only as needed. D) Notify your physician if blood glucose levels rise above the level set for you.

A, B, D Oral hypoglycemic drugs must be taken on a daily scheduled basis to maintain euglycemia and prevent long-term complications of diabetes. All other options are correc

When caring for a patient newly diagnosed with gestational diabetes, the nurse would question an order for which drug? A) insulin glargine (Lantus) B) glipizide (Glucotrol) C) insulin glulisine (Apidra) D) NPH insulin (Humulin N

B All currently available oral antidiabetic drugs are contraindicated for pregnant patients. *read the f**king question

Which oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat? A) acarbose (Precose) B) metformin (Glucophage) C) repaglinide (Prandin) D) rosiglitazone (Avandia)

C Repaglinide is known as the "Humalog of oral hypoglycemic drugs." The drug's very fast onset of action allows patients to take the drug with meals and skip a dose when they skip a meal.

The nurse would include which statement when teaching a patient about insulin glargine? A) "You should inject this insulin just before meals because it is very fast acting." B) "The duration of action for this insulin is approximately 8 to10 hours, so you will need to take it twice a day." C) "You can mix this insulin with NPH insulin to enhance its effects." D) "You cannot mix this insulin with regular insulin and thus will have to take two injections."

D Insulin glargine is a long-acting insulin with duration of action up to 24 hours. It should not be mixed with any other insulins.

A patient with type 1 DM is admitted to the medical unit with an acute exacerbation of chronic obstructive pulmonary disease. He is placed on IV piggyback antibiotics, nebulizer treatments with albuterol, and an IV corticosteroid, and he is also taking a proton pump inhibitor for gastroesophageal reflux disease. He takes a dose of glargine insulin every evening. This evening the nurse notes that his blood glucose level is 170 mg/dL. The next morning, his fasting glucose level is 202 mg/dL. What is the most likely cause of his elevated glucose levels? A. The albuterol B. The antibiotics C. The proton pump inhibitor D. The corticosteroid

D: the corticosteroid

Nursing Implications of insulin Insulin -When drawing up two types of insulin in one syringe, always withdraw the regular or rapid-acting insulin first. -Provide thorough patient education regarding self-administration of insulin injections, including timing of doses, monitoring blood glucose levels, and injection site rotations.

TWO NURSES MUST GIVE -Check blood glucose level before giving insulin. -Roll vials between hands instead of shaking to mix -Only use insulin syringes, calibrated in units, to measure and give insulin. -Insulin order and prepared dosages are second checked with another nurse.

A patient is taking metformin for new-onset type 2 diabetes mellitus. When reviewing potential adverse effects, the nurse will include information about: (Select all that apply.) a Abdominal bloating b Nausea c Diarrhea d Headache e Weight gain f Metallic taste

a) Abdominal bloating b) Nausea c) Diarrhea f) Metallic taste

Diabetic teaching includes treatment of hypoglycemia with which drug? A) propranolol (Inderal) B) glucagon C) acarbose (Precose) D) bumetanide (Bumex)

b glucagon Glucagon stimulates glycogenolysis, raising serum glucose levels.